Perfil sociodemográfico e de formação dos enfermeiros atuantes na atenção primária à saúde no Distrito Federal / Sociodemographic and training profile of nurses working in primary care health in the Federal District / Perfil sociodemográfico y formativo de los enfermeiros que actúan em atención primaria salud en el Distrito Federal

O objetivo do artigo foi analisar o perfil sociodemográfico e de formação acadêmica dos enfermeiros atuantes na Atenção Primária à Saúde no Distrito Federal. Os dados são oriundos da pesquisa "Práticas de Enfermagem no Contexto da Atenção Primária à Saúde: estudo nacional de métodos mistos"; foram coletados por questionário eletrônico e analisados pelo Statistical Package for the Social Sciences. Responderam ao questionário 329 enfermeiros incluídos pelos critérios de atuação em equipes de saúde da família ou cargos de gestão da atenção primária há pelo menos dois anos, que aceitaram participar do estudo nacional que originou os dados. Foram excluídos enfermeiros residentes, de licença de qualquer natureza ou que tenham recusado a participação. O estudo mostrou perfil sociodemográfico majoritariamente feminino, de meia idade, maioria de pessoas negras/pardas, casadas, católicas. A maioria dos profissionais não nasceu no município onde trabalha, mas optou por nele residir, e atua há 12 anos ou mais. Quanto à formação, a maior parte é graduada em instituições de ensino privadas brasileiras, com grande contingente de especialistas e quantidade reduzida de mestres, doutores e pós doutores. Nota-se influência da formação histórica e social da profissão no perfil da categoria, atravessada por questões elitistas, sexistas e racistas, interligadas às práticas de enfermagem, à estruturação do mundo do trabalho e ao reconhecimento social da profissional. Portanto, é necessário romper com o paradigma sociocultural e histórico excludente da formação profissional, para o progresso da autonomia, do reconhecimento e da valorização profissional. (AU)

The objective of the article was to analyze the sociodemographic profile and academic background of nurses working in Primary Health Care in the Federal District. Data come from the research "Nursing Practices in the Context of Primary Health Care: national study of mixed methods"; were collected by electronic questionnaire and analyzed using the Statistical Package for the Social Sciences. The questionnaire was answered by 329 nurses included according to the criteria of working in family health teams or in primary care management positions for at least two years, who agreed to participate in the national study that originated the data. Resident nurses, nurses on leave of any kind or those who refused to participate were excluded. The study showed a sociodemographic profile that was mostly female, middle-aged, mostly black/brown, married, Catholic. Most professionals were not born in the municipality where they work, but chose to live there, and have been working there for 12 years or more. As for training, the majority graduated from Brazilian private educational institutions, with a large contingent of specialists and a small number of masters, doctors and post-doctors. The influence of the profession's historical and social formation on the category's profile is noted, crossed by elitist, sexist and racist issues, interconnected with nursing practices, the structuring of the world of work and the social recognition of the professional. Therefore, it is necessary to break with the sociocultural and historical paradigm that excludes professional training, for the progress of autonomy, recognition and professional valuation. (AU)

El objetivo del artículo fue analizar el perfil sociodemográfico y la formación académica de los enfermeros que actúan en la Atención Primaria de Salud del Distrito Federal. Los datos provienen de la investigación "Prácticas de Enfermería en el Contexto de la Atención Primaria de Salud: estudio nacional de métodos mixtos"; fueron recogidos por cuestionario electrónico y analizados utilizando el Paquete Estadístico para las Ciencias Sociales. El cuestionario fue respondido por 329 enfermeros incluidos según el criterio de actuar en equipos de salud de la familia o en cargos de gestión de la atención primaria durante al menos dos años, que aceptaron participar en el estudio nacional que originó los datos. Se excluyeron las enfermeras residentes, las enfermeras con licencia de cualquier tipo o las que se negaron a participar. El estudio mostró un perfil sociodemográfico mayoritariamente femenino, de mediana edad, mayoritariamente negro/moreno, casado, católico. La mayoría de los profesionales no nacieron en el municipio donde trabajan, sino que eligieron vivir allí y tienen 12 años o más trabajando allí. En cuanto a la formación, la mayoría se graduó en instituciones educativas privadas brasileñas, con un gran contingente de especialistas y un pequeño número de maestros, doctores y posdoctorados. Se nota la influencia de la formación histórica y social de la profesión en el perfil de la categoría, atravesada por cuestiones elitistas, sexistas y racistas, interconectadas con las prácticas de enfermería, la estructuración del mundo del trabajo y el reconocimiento social del profesional. Por tanto, es necesario romper con el paradigma sociocultural e histórico que excluye la formación profesional, para el progreso de la autonomía, el reconocimiento y la valoración profesional. (AU)

Estado da arte e perspectivas da reabilitação cardiovascular no Brasil / State of the art and perspectives for cardiovascular rehabilitation in Brazil

Introdução: Inúmeros benefícios dos programas de reabilitação cardiovascular (PRC) já foram documentados por meio de ensaios clínicos randomizados e meta-análises. Porém, as doenças crônicas não transmissíveis, sobretudo as doenças cardiovasculares (DCV), vêm aumentando no Brasil. Existe uma grande lacuna entre o conhecimento e a recomendação desta estratégia para prevenção de DVC, uma carência de serviços de reabilitação cardiovascular (RCV) vinculados ao Sistema Único de Saúde (SUS), uma falta de universalização do serviço em todas as esferas, bem como falta de um sistema de integração que os englobe. Objetivo: Escrutinar os motivos de a RCV ainda não ter sido universalizada pelo SUS. Métodos: Revisão narrativa realizada em sistemas de bibliotecas online e motores de busca, análise documental em sites oficiais do governo brasileiro, site do Sistema de Auditoria do SUS, manuais do Ministério da Saúde, e regulamentações revogadas citadas em legislações atualizadas. Resultados: Existem barreiras transponíveis relacionadas aos níveis do provedor e do sistema para melhor adesão dos pacientes aos PRC. Conclusão: Devem ser fomentadas ações de encaminhamento para PRC antes da alta hospitalar, melhorar a informação e o treinamento relacionado aos benefícios da RCV para profissionais da atenção primária e propor manuais de conduta para contrapor a falta de encaminhamento.

Emotional disorders, parafunctional habits, and bruxism in hospital healthcare professionals in the COVID-19 post-pandemic period: a cross-sectional observational study / Alterações emocionais, hábitos parafuncionais e bruxismo em profissionais de saúde de ambiente hospitalar no período pós-pandemia de COVID-19: um estudo observacional descritivo / Cambios emocionales, hábitos parafuncionales y bruxismo en profesionales de la salud en el ámbito hospitalario en el período pospandemia por COVID-19: un estudio observacional descriptivo

ABSTRACT During the COVID-19 pandemic, hospital healthcare professionals (HHP) were vulnerable to sources of anxiety that can lead to the onset or worsening of conditions such as bruxism and parafunctional habits (PH). This study aims to evaluate the relationship between sleep bruxism (SB), awake bruxism (AB), and PH and HHP's stress, anxiety, and depression in the post-pandemic period. Data were collected via an online questionnaire composed of four sections: sample characterization, "Depression, Anxiety and Stress Scale" (DASS-21), "Oral Behavior Checklist" (OBC), and diagnostic questionnaire of SB from the American Academy of Sleep Medicine. This is a descriptive and inferential statistical analysis with 118 responses (mostly females and nurses). A total of 99.2% of the sample presented PH, 38.1% SB, and 686% AB. We found a significant association between AB and stress (p=0029), anxiety (p=0005), and depression (p=0.004); SB and anxiety (p=0.013); and between SB and AB and emotional changes in the studied sample.

RESUMO Durante a pandemia da COVID-19, os profissionais de saúde de ambiente hospitalar (PSAH) estiveram vulneráveis a fontes de ansiedade que podem conduzir ao surgimento ou agravamento de condições como o bruxismo e os hábitos parafuncionais. Foi objetivo deste estudo avaliar a relação entre o bruxismo do sono (BS), da vigília (BV) e os hábitos parafuncionais (HP) e o estresse, a ansiedade e a depressão em PSAH no período pós-pandemia. Os dados foram recolhidos através de questionário online dividido em quatro secções: caracterização da amostra, escala de ansiedade, depressão e estresse (EADS-21), lista de avaliação de comportamentos orais (Laco) e questionário de diagnóstico de BS da Academia Americana de Medicina do Sono. Em seguida, procedeu-se à análise estatística descritiva e inferencial. A amostra foi composta de 118 respostas, sendo a maioria do sexo feminino e enfermeiros. Do total, 99,2% apresentou HP, 38,1% BS e 68,6% BV. Houve associação significativa entre BV e estresse (p=0,029), ansiedade (p=0,005) e depressão (p=0,004); entre BS e ansiedade (p=0,013); e entre BS e BV e as alterações emocionais na amostra em estudo.

RESUMEN Durante la pandemia del COVID-19, los profesionales de la salud en el ámbito hospitalario (PSAH) estuvieron expuestos a focos de ansiedad que podían conducirles al surgimiento o empeoramiento de condiciones como el bruxismo y hábitos parafuncionales. El objetivo de este estudio fue evaluar la relación entre el bruxismo del sueño (BS), bruxismo de la vigilia (BV) y hábitos parafuncionales (HP) con el estrés, la ansiedad y la depresión en PSAH en el período pospandémico. Los datos se recolectaron de un cuestionario en línea, dividido en cuatro secciones: caracterización de la muestra, escala de ansiedad, depresión y estrés (EADS-21), lista de evaluación del comportamiento oral (LACO) y cuestionario de diagnóstico de BS de la Academia Americana de Medicina del Sueño. Luego, se realizó un análisis estadístico descriptivo e inferencial. La muestra constó de 118 respuestas, y su mayoría era mujeres y enfermeras. Del total, el 99,2% tenía HP; el 38,1% BS; y el 68,6% BV. Hubo asociación significativa entre BV y estrés (p=0,029), ansiedad (p=0,005) y depresión (p=0,004); entre BS y ansiedad (p=0,013); y entre BS y BV, además de cambios emocionales en la muestra del estudio.

Management of periapical lesion with persistent exsudate.

This case describes the treatment and follow-up of a mandibular molar in an 18-year-old female with a periapical cyst. Thus, it becomes important to know which options should we take when faced with a clinical situation that we cannot resolve through conventional methods, and which techniques and approaches we have to achieve treatment success. This case showed the treatment plan and follow-up, by the use of CBCT images, from a previously treated mandibular molar with a large periapical abscess and cystic lesion, in which, the first treatment plan approach was to make the endodontic retreatment. During the chemo-mechanical preparation the presence of permanent intracanal purulent exudate made it impossible to dry the canals, impeding obturation of the root canal system. Due to this clinical situation, a surgical approach was performed with the intention of reduce this permanent exudate and to execute a decompression technique. Clinical findings, periapical radiographs and cone beam computed tomographic, indicated almost complete resolution of the radiolucency, after a one-year follow-up.

Este relato de caso descreve o tratamento e acompanhamento de um molar inferior em uma jovem de 18 anos com cisto periapical. Assim, torna-se importante saber quais opções devemos tomar diante de uma situação clínica que não podemos resolver pelos métodos convencionais, e quais técnicas e abordagens temos para alcançar o sucesso do tratamento. Este caso mostrou o plano de tratamento e acompanhamento, por meio de imagens de tomografia computadorizada de feixe cônico (TCFC), de um molar inferior previamente tratado com grande abscesso periapical e lesão cística, no qual, a primeira abordagem do plano de tratamento foi fazer o retratamento endodôntico. Durante o preparo químico-mecânico a presença de exsudato purulento intracanal permanente impossibilitou a secagem dos canais, impedindo a obturação do sistema de canais radiculares. Devido a essa situação clínica, foi realizada abordagem cirúrgica com a intenção de reduzir esse exsudato permanente e executar uma técnica de descompressão. Após um ano de acompanhamento, os achados clínicos e radiográficos indicaram processo de reparo.

Management of periapical lesion with persistent exsudate

Resumo Este relato de caso descreve o tratamento e acompanhamento de um molar inferior em uma jovem de 18 anos com cisto periapical. Assim, torna-se importante saber quais opções devemos tomar diante de uma situação clínica que não podemos resolver pelos métodos convencionais, e quais técnicas e abordagens temos para alcançar o sucesso do tratamento. Este caso mostrou o plano de tratamento e acompanhamento, por meio de imagens de tomografia computadorizada de feixe cônico (TCFC), de um molar inferior previamente tratado com grande abscesso periapical e lesão cística, no qual, a primeira abordagem do plano de tratamento foi fazer o retratamento endodôntico. Durante o preparo químico-mecânico a presença de exsudato purulento intracanal permanente impossibilitou a secagem dos canais, impedindo a obturação do sistema de canais radiculares. Devido a essa situação clínica, foi realizada abordagem cirúrgica com a intenção de reduzir esse exsudato permanente e executar uma técnica de descompressão. Após um ano de acompanhamento, os achados clínicos e radiográficos indicaram processo de reparo.

Abstract This case describes the treatment and follow-up of a mandibular molar in an 18-year-old female with a periapical cyst. Thus, it becomes important to know which options should we take when faced with a clinical situation that we cannot resolve through conventional methods, and which techniques and approaches we have to achieve treatment success. This case showed the treatment plan and follow-up, by the use of CBCT images, from a previously treated mandibular molar with a large periapical abscess and cystic lesion, in which, the first treatment plan approach was to make the endodontic retreatment. During the chemo-mechanical preparation the presence of permanent intracanal purulent exudate made it impossible to dry the canals, impeding obturation of the root canal system. Due to this clinical situation, a surgical approach was performed with the intention of reduce this permanent exudate and to execute a decompression technique. Clinical findings, periapical radiographs and cone beam computed tomographic, indicated almost complete resolution of the radiolucency, after a one-year follow-up.

Better Adequacy of Food Intake According to Dietary Recommendations of National Cholesterol Education Program in Vegetarian Compared to Omnivorous Men

Abstract Background The lower frequency of cardiovascular (CV) risk factors observed in vegetarians compared to omnivores may be due to more appropriate nutrient intake according to recommendations for the prevention of cardiovascular diseases. Objective To compare the dietary adequacy according to the recommendations of the National Cholesterol Education Program (NCEP) in apparently healthy vegetarian (VEG) and omnivorous (OMN) men. Methods This was a cross-sectional study, conducted with apparently healthy men (44 omnivorous and 44 vegetarians, ≥ 35 years), who were assessed for daily food consumption, anthropometric data, physical exercise status, and clinical data. Multiple logistic regression was used to test the association between the type of diet and the dietary adequacy. Significant values were considered for p<0.05. Results Several clinical CV risk markers were significantly lower in VEG when compared to OMN: body mass index (BMI) (23.1 vs. 27.3 kg/m2), systolic blood pressure (119.5 vs. 129.2 mmHg), and diastolic blood pressure (75.7 vs. 83.9 mmHg). VEG presented significant lower values of blood lipids and glucose. No significant difference was observed in caloric intake; however, VEG consumed significantly more carbohydrates, dietary fibers, and polyunsaturated fats. VEG presented an adequate consumption of dietary cholesterol and saturated and polyunsaturated fatty acids, regardless of caloric intake and age. Conclusion VEG were more likely to consume saturated fatty acids, dietary cholesterol, and fibers according to the recommendations of NCEP, factors that may contribute to lower levels of CV risk markers than OMN.

Prevalence of bruxism in adults with cerebral palsy institutionalized in Lisbon.

OBJECTIVE: To determine the prevalence of bruxism in individuals with cerebral palsy (CP) and evaluating the various factors associated METHODS: One hundred and ten adults diagnosed with CP were selected from six institutions for people with special needs. Data were collected through oral examinations using the diagnostic criteria proposed by the American Academy of Sleep Medicine and the modified scale of Asworth RESULTS: Of the total sample, spastic tetraplegia was the most common type and half of the population presents severe intellectual disability. The prevalence of bruxism was 74,5%. Wear facets were observed in 67.9% of the sample, 59.1% of which were brilliant. There was a positive association between mixed bruxism (MB) and the spasticity classification. Through a logistic regression it was found that the risk of having MB and general bruxism (GB) is greater in individuals who have shiny wear facets. CONCLUSIONS: In the present study the high prevalence of GB indicates there is an urgent need for treatment options in people with CP. More studies are needed with standardized diagnostic protocols and representative samples to evaluate the factors that influence the presence of bruxism in this population and to establish an appropriate treatment planning.

Aplicación del Método Autorregresivo Integrado de Medias Móviles para el análisis de series de casos de COVID-19 en el Perú / Application Of The Integrated Autoregressive Method Of Moving Averages For The Analysis Of Series Of Cases Of COVID-19 In Peru

Objetivo: Estimar un modelo Autorregresivo Integrado de Medias Móviles (ARIMA) para el análisis de series de casos de COVID-19, en Perú. Métodos: El presente estudio se basó en un análisis de series temporales univariante; los datos utilizados se refieren a la cantidad de casos nuevos acumulados de COVID-19 del 06 de marzo al 11 de junio de 2020. Para el análisis del ajuste del modelo se utilizaron los coeficientes de autocorrelación (ACF), el contraste de raíces unitarias de Dickey-Fuller Aumentado (ADF), el Criterio de Información Bayesiano Normalizado (BIC Normalizado), el error porcentual medio absoluto (MAPE) y el test de Box-Ljung. Resultados: El pronóstico de casos de COVID-19, entre el 12 de junio al 11 de julio de 2020 oscila entre 220 596 a 429 790. Conclusiones: Los resultados obtenidos con el modelo ARIMA, comparados con los datos observados, muestran un ajuste adecuado de los valores; y aunque este modelo, de fácil aplicación e interpretación, no simula el comportamiento exacto en el tiempo puede considerarse una herramienta simple e inmediata para aproximar el numero de casos.

Objective: To estimate an Integrated Autoregressive Moving Average model (ARIMA) for the analysis of series of COVID-19 cases, in Peru. Methods: The present study was based on a univariate time series analysis; The data used refer to the number of new accumulated cases of COVID-19 from March 6 to June 11, 2020. For the analysis of the fit of the model, the autocorrelation coefficients (ACF), the unit root test of Augmented Dickey-Fuller (ADF), the Normalized Bayesian Information Criterion (Normalized BIC), the absolute mean percentage error (MAPE) and the Box-Ljung test. Results: The prognosis for COVID-19 cases, between June 12 and July 11, 2020 ranges from 220 596 to 429 790. Conclusions: The results obtained with the ARIMA model, compared with the observed data, show an adequate adjustment of the values; And although this model, easy to apply and interpret, does not simulate the exact behavior over time, it can be considered a simple and immediate tool to approximate the number of cases.

Precisión del pronóstico de la dinámica de propagación de la COVID-19 en Perú / Forecast accuracy of COVID-19 spread dynamics in Peru

RESUMEN Objetivo Analizar la precisión del pronóstico del modelo suavizado de Brown para predecir la propagación de la COVID-19 en Perú, entre el 6 de marzo al 30 de mayo del 2020. Materiales y métodos Estudio descriptivo basado en un análisis de series de tiempo correspondiente al período comprendido entre el 6 de marzo al 30 de mayo del 2020 en Perú. Se utilizó la información de la cantidad de casos positivos de COVID-19 (155 671 personas). El modelo empleado como método de predicción fue el pronóstico suavizado de Brown que consiste en realizar dos suavizaciones exponenciales, a partir de las cuales se calcula el pronóstico: en la primera se emplean los valores observados en la serie de tiempo; y la segunda, la serie que ha sido obtenida mediante la primera atenuación. Las medidas de precisión utilizadas fueron el error medio del pronóstico (EMP), el error medio al cuadrado (EMC), la desviación absoluta de la media (DAM) y el porcentaje de error medio absoluto (PEMA). Para determinar si los datos se ajustan al modelo evaluado se utilizó el coeficiente de determinación (R2). Resultados El error medio del pronóstico (EMP) fue de 156,7; el error medio al cuadrado (EMC) fue de 506461,3; la desviación absoluta de la media (DAM) fue 450,6 y el porcentaje de error medio absoluto (PEMA) fue 9,03 %. El coeficiente de determinación (R2) fue de 0,8078. Conclusiones El error de precisión o porcentaje de error medio absoluto (PEMA) fue del 9,03 %, con un coeficiente de determinación (R2) de 0,8078; lo que indica que los datos se ajustan en un 80,78 % al modelo evaluado.

ABSTRACT Objective To analyze the forecast accuracy of Brown's exponential smoothing model to predict the spread of COVID-19 in Peru from March 6 to May 30, 2020. Materials and methods A descriptive study based on a time series analysis conducted from March 6 to May 30, 2020 in Peru. The information on the number of positive cases of COVID-19 (155,671 people) was used. The prediction method was Brown's exponential smoothing model, which consists in carrying out two exponential smoothings from which the forecast is calculated: the time series values were used in the first smoothing, and the first attenuation series was used in the second one. Accuracy measures used in the research were: mean forecast error (MFE), mean squared error (MSE), mean absolute deviation (MAD) and mean absolute percentage error (MAPE). The coefficient of determination (R2) was used to establish if the data fits the evaluated model. Results MFE was 156.7, MSE was 506461.3, MAD was 450.6 and MAPE was 9.03 %. R2 accounted for 0.8078. Conclusions Accuracy error or MAPE was 9.03 % and R2 was 0.8078, which indicates that the data fits by 80.78 % to the evaluated model.

Neoplasia oncocítica adrenocortical de potencial maligno incierto: reporte de un caso / Adrenocortical oncocytic neoplasm with uncertain malignant potential: a case report

Resumen Objetivo Describir el caso clínico de una paciente con neoplasia oncocitica adrenocortical, tratado quirúrgicamente en una clínica de Lima, Perú. Caso clínico Paciente mujer de 26 años ingresa a emergencia por dolor abdominal inespecífico. Se evidencia tumoración de 15x14x12 cm dependiente de glándula suprarrenal izquierda por lo que se decide tratamiento quirúrgico. Al análisis patológico se evidencia neoplasia oncocítica de potencial maligno incierto. Discusión Las neoplasias oncocíticas adrenocorticales son entidades poco frecuentes, con escasos reportes de casos de esta enfermedad. Para clasificarlas, se usa la escala de Weiss modificada. Obtenemos una neoplasia oncocítica de potencial maligno incierto, cuyo tratamiento incluye la cirugía de resección de tumor y observación. Conclusión Considerar a las neoplasias oncocíticas dentro del diagnóstico diferencial de incidentalomas adrenales.

Objective To describe a case report of a oncocytic adrenocortical neoplasm, treated surgically in a clinic in Lima, Peru. Case report A 26-year-old woman is admitted to the emergency due to nonspecific abdominal pain. A tumor measuring 15x14x12 cm dependent on left adrenal gland is evidenced, so surgical treatment is decided. Pathological analysis evidences oncocytic neoplasia of uncertain malignant potential. Discussion Oncocytic adrenocortical neoplasms are rare entities, with few case reports of this disease. To classify them, the modified Weiss scale is used. We obtain an oncocytic neoplasm of uncertain malignant potential, whose treatment includes surgery for tumor resection and observation. Conclusion Consider oncocytic neoplasms within the differential diagnosis of adrenal incidentalomas.

Prevalencia de infecciones respiratorias agudas en niños menores de 5 años en un centro materno-infantil de Lima / Prevalence of acute respiratory infections in children under 5 years of age at a maternal-child health center in Lima

RESUMEN Objetivo Conocer la prevalencia de infecciones respiratorias agudas en niños menores de 5 años en un centro materno-infantil de Lima. Materiales y métodos Estudio descriptivo, observacional, transversal y retrospectivo, realizado en un centro materno- infantil de Lima, durante los meses de enero y setiembre del 2018, en una población de 4050 historias clínicas. Los criterios de inclusión fueron que las historias clínicas sean legibles y que presentaran datos completos. Se utilizó estadística descriptiva. Resultados La prevalencia de infecciones respiratorias agudas fue de 30,47 %. Según sexo, fue de 31,8 % para el sexo masculino y 29,2 % para el sexo femenino. La prevalencia también se calculó según edad: menores de 1 año (29,5 %), niños de 2 años (29,2 %), 3 años (35,3 %), 30,7 % para el grupo de 4 años, y 28,0 % en niños de 5 años. La mayor prevalencia se encontró en abril (59,4 %), seguido por marzo (46,8 %), mayo (42,0 %), y agosto (menor número de casos). Conclusiones La prevalencia de infecciones respiratorias agudas en un centro materno-infantil de Lima fue de 30,47 %. Es mayor en los niños de 3 años y en el mes de abril.

ABSTRACT Objective To know the prevalence of acute respiratory infections in children under 5 years of age at a maternal-child health center in Lima. Materials and methods This descriptive, observational, cross-sectional and retrospective study was conducted using 4,050 medical records from a maternal-child health center in Lima between January and September 2018. Inclusion criteria included legible and comprehensive medical records. Descriptive statistics was used. Results The prevalence of acute respiratory infections was 30.47 %. Sex-adjusted prevalence was 31.8 % in males and 29.2 % in females. Age-adjusted prevalence was 29.5 % in children under 1 year old, 29.2 % in 2-year-old children, 35.3 % in 3-year-old children, 30.7 % in 4-year-old children and 28.0 % in 5-year-old children. The highest prevalence was found in April (59.4 %), followed by March (46.8 %), May (42.0 %) and August (the month with fewer cases). Conclusions The prevalence of acute respiratory infections at a maternal-child health center in Lima was 30.47 %. The highest prevalence was observed in 3-year-old children and in April.

Paraganglioma presenting as stress cardiomyopathy: case report and literature review.

Pheochromocytoma/paraganglioma (PPGL) are neuroendocrine tumors that can secrete catecholamines. The authors describe a challenging case who presented as stress cardiomyopathy and myocardial infarction (MI). A 76-year-old man, with a medical history of Parkinson's disease, type 2 diabetes mellitus, hypertension, dyslipidaemia and a previous inferior MI in 2001, presented to the emergency department due to chest pain, headaches and vomiting. He also reported worsening blood glucose levels and increasing constipation over the preceding weeks. BP was 185/89 mmHg (no other relevant findings). EKG had ST segment depression in leads V2-V6, T troponin was 600 ng/L (<14) and the echocardiogram showed left ventricular hypokinesia with mildly compromised systolic function. Nevertheless, he rapidly progressed to severe biventricular dysfunction. Coronary angiogram showed a 90% anterior descendent coronary artery occlusion (already present in 2001), which was treated with angioplasty/stenting. In the following days, a very labile BP profile and unexplained sinus tachycardia episodes were observed. Because of sustained severe constipation, the patient underwent an abdominal CT that revealed a retroperitoneal, heterogeneous, hypervascular mass on the right (62 × 35 mm), most likely a paraganglioma. Urinary metanephrines were increased several fold. 68Ga-DOTANOC PET-CT scan showed increased uptake in the abdominal mass (no evidence of disease elsewhere). He was started on a calcium-channel blocker and alpha blockade and underwent surgery with no major complications. Eight months after surgery, the patient has no evidence of disease. Genetic testing was negative for known germline mutations. This was a challenging diagnosis, but it was essential for adequate cardiovascular stabilization and to reduce further morbidity. Learning points: PPGL frequently produces catecholamines and can manifest with several cardiovascular syndromes, including stress cardiomyopathy and myocardial infarction. Even in the presence of coronary artery disease (CAD), PPGL should be suspected if signs or symptoms attributed to catecholamine excess are present (in this case, high blood pressure, worsening hyperglycaemia and constipation). Establishing the correct diagnosis is important for adequate treatment choice. Inodilators and mechanical support might be preferable options (if available) for cardiovascular stabilization prior to alpha blockade and surgery. Laboratory interference should be suspected irrespective of metanephrine levels, especially in the context of treated Parkinson's disease.

Effect of light intensity and processing conditions on bioactive compounds in maté extracted from yerba mate (Ilex paraguariensis A. St.-Hil.).

This is the first report investigating the effects of cultivation, growth under full sunlight (MSL) or shade (MS), and processing (drying, sapeco and roasting) on the composition and antioxidant potential of maté. Samples were roasted (180 °C, 200 °C, 220 °C or 240 °C) for a fixed time (10 min) or roasted (10, 20, 30 or 40 min) at a fixed temperature (200 °C). HPLC/UV/MS analysis and measures of total phenolic content (TPC) and antioxidant activity (2,2-diphenyl-1-picrylhydrazyl (DPPH) inhibition and soybean oil oxidation) were used to analyse phytochemicals. There were significant differences (p < 0.05, ANOVA/Tukey) in phenolics between MS and MSL samples following certain processing steps, but Principal Component Analysis (PCA) indicated no distinction between MS and MSL samples, suggesting that light intensity had no effect on phenolics. Caffeine increased significantly (p < 0.05) in MS samples. Temperature was more important than time, since pyrolysis of phenolics was more intense at 240 °C.

Factores asociados al estrés en estudiantes de odontología de una universidad peruana / Stress factors associated with dental students of a Peruvian university

Objetivos: Determinar los factores asociados al estrés en estudiantes de la Facultad de Odontología de una Universidad Peruana. Material y Métodos: El estudio fue no experimental y transversal realizado durante abril y mayo del 2016. La muestra fue de 140 estudiantes de Odontología seleccionada por muestreo no probabilístico; los criterios de selección fueron todos los estudiantes de ambos sexos matriculados en el semestre académico y que firmaran el consentimiento informado, los datos para determinar la presencia de estrés se obtuvieron mediante la aplicación del cuestionario "Dental Environment Stress Questionaire". Para evaluar la asociación entre el estrés y la edad, sexo y nivel académico se utilizó la prueba Chi-cuadrado, se calcularon los odds ratio (OR). Resultados: El estrés académico se presentó en el 75,7% de los estudiantes y se encontró una asociación estadísticamente significativa con el nivel académico de los estudiantes (p <0,05) observándose mayor estrés en el nivel preclínico que en el nivel clínico; y con la edad de los estudiantes (p<0,05) observándose mayor estrés en los adultos jóvenes que en los adultos. Conclusiones: La mayoría de los estudiantes de odontología de una universidad peruana presentan estrés académico, el cual está asociado al nivel académico y a la edad.

Objectives: Determine the factors associated with stress in students of the Dental School of a Peruvian University. Material and Methods: The study was non-experimental and cross-sectional conducted during April and May 2016. The sample was 140 dentistry students selected by non-probabilistic sampling; the selection criteria were all students of both sexes enrolled in the academic semester and who signed the informed consent, the data to determine the presence of stress were obtained by applying the questionnaire "Dental Environment, Questionnaire". To evaluate the association between stress and age, sex and academic level, the chi-square test was used, the odds ratio (OR) was calculated. Results: Academic stress was presented in 75,7% of the students and a statistically significant association was found with the academic level of the students (p <0,05), observing greater stress at the preclinical level than at the clinical one; and with the age of the students (p <0,05) observing greater stress in young adults than in adults. Conclusions: The majority of dentistry students of a Peruvian university present academic stress, which is associated with academic level and age.

Prevalence of Metabolic Syndrome and Framingham Risk Score in Apparently Healthy Vegetarian and Omnivorous Men.

BACKGROUND: Recent studies have shown a lower prevalence of metabolic syndrome (MSyn) in vegetarians (VEG) despite the inconclusive evidence from others. OBJECTIVE: To verify the association between diet and other lifestyle characteristics and the prevalence of MSyn, cardiovascular risk factors (CRF), and Framingham Risk Score (FRS) in apparently healthy VEG and omnivorous (OMN) men. METHODS: In this cross-sectional study, 88 apparently healthy men ≥ 35 years, 44 VEG and 44 OMN, were assessed for anthropometric data, blood pressure, blood lipids, glucose, C-reactive protein (CRP) and FRS. To test the association between lifestyle and MSyn, Student t test, chi-square test, and multiple logistic regression model were used. A significance level of 5% was considered in all statistical analyses. RESULTS: Several CRF were significantly lower in VEG than in OMN: body mass index, systolic blood pressure, diastolic blood pressure, fasting serum total cholesterol, LDL-cholesterol, apolipoprotein b, glucose, and glycated hemoglobin (all p < 0.05). The FRS mean was lower in VEG than in OMN (2.98 ± 3.7 vs 4.82 ± 4.8, p = 0.029). The percentage of individuals with MSyn was higher among OMN than among VEG (52.3 vs.15.9%) (p < 0.001). The OMN diet was associated with MSyn (OR: 6.28 95%CI 2.11-18.71) and alterations in most MSyn components in the multiple regression model independently of caloric intake, age and physical activity. CONCLUSION: The VEG diet was associated with lower CRF, FRS and percentage of individuals with MSyn.

Prevalence of Metabolic Syndrome and Framingham Risk Score in Apparently Healthy Vegetarian and Omnivorous Men / Prevalência de Síndrome Metabólica e Escore de Risco de Framingham em Homens Vegetarianos e Onívoros Aparentemente Saudáveis

Abstract Background: Recent studies have shown a lower prevalence of metabolic syndrome (MSyn) in vegetarians (VEG) despite the inconclusive evidence from others. Objective: To verify the association between diet and other lifestyle characteristics and the prevalence of MSyn, cardiovascular risk factors (CRF), and Framingham Risk Score (FRS) in apparently healthy VEG and omnivorous (OMN) men. Methods: In this cross-sectional study, 88 apparently healthy men ≥ 35 years, 44 VEG and 44 OMN, were assessed for anthropometric data, blood pressure, blood lipids, glucose, C-reactive protein (CRP) and FRS. To test the association between lifestyle and MSyn, Student t test, chi-square test, and multiple logistic regression model were used. A significance level of 5% was considered in all statistical analyses. Results: Several CRF were significantly lower in VEG than in OMN: body mass index, systolic blood pressure, diastolic blood pressure, fasting serum total cholesterol, LDL-cholesterol, apolipoprotein b, glucose, and glycated hemoglobin (all p < 0.05). The FRS mean was lower in VEG than in OMN (2.98 ± 3.7 vs 4.82 ± 4.8, p = 0.029). The percentage of individuals with MSyn was higher among OMN than among VEG (52.3 vs.15.9%) (p < 0.001). The OMN diet was associated with MSyn (OR: 6.28 95%CI 2.11-18.71) and alterations in most MSyn components in the multiple regression model independently of caloric intake, age and physical activity. Conclusion: The VEG diet was associated with lower CRF, FRS and percentage of individuals with MSyn.

Resumo Fundamento: Estudos recentes mostraram menor prevalência de Síndrome Metabólica (SM) em vegetarianos (VEG), apesar de evidências inconclusivas de outros. Objetivo: Verificar associação entre dieta e características do estilo de vida e a prevalência de SM, fatores de risco cardiovascular (FRCV) e Escore de Framingham (EF) em homens VEG e onívoros (ONI) aparentemente saudáveis. Métodos: Neste estudo transversal, 88 homens aparentemente saudáveis ≥ 35 anos, VEG (n = 44) e ONI (n = 44), foram avaliados quanto a dados antropométricos, pressão arterial, lípides plasmáticos, glicemia, proteína C reativa e EF. Para testar associação entre estilo de vida e SM, o teste t de Student, o teste qui-quadrado e a regressão logística múltipla foram utilizados. Foi considerado nível de significância de 5% em todas as análises estatísticas. Resultados: Os níveis dos FRCV avaliados foram menores nos VEG do que nos ONI: índice de massa corporal, pressão arterial sistólica e diastólica, colesterol total, LDL-colesterol, apolipoproteína b, glicemia e hemoglobina glicada (p < 0,05). O EF foi menor nos VEG do que nos ONI (2,98 ± 3,7 vs. 4,82 ± 4,8; p = 0,029). A porcentagem de indivíduos com SM foi maior entre ONI do que entre VEG (52,3 vs.15,9%) (p < 0,001). A dieta ONI foi associada com a SM (OR: 6,28 IC95% 2,11-18,71) e alterações na maioria dos componentes da SM no modelo de regressão logística múltipla, independentemente de ingestão calórica, idade e atividade física. Conclusão: A dieta VEG foi associada com menores taxas de FRC e menores EF e porcentagem de indivíduos com SM.

Niveles de ansiedad en pacientes adultos de una clínica odontológica en una universidad peruana / Levels of anxiety in adult patients of a dental clinic in a Peruvian university

Objetivos: Determinar los niveles de ansiedad en pacientes adultos que acuden a la clínica odontológica de una universidad peruana. Material y Métodos: El estudio fue no experimental y transversal realizado durante el mes de setiembre del 2016. La muestra estuvo constituida por 120 pacientes que acudieron a la clínica odontológica de una universidad peruana la cual fue seleccionada por muestreo no probabilístico. Los criterios de selección fueron todos los pacientes de ambos sexos, mayores de 18 años, haber sido atendidos en más de dos ocasiones y que firmaron la carta de consentimiento informado, los datos para determinar los niveles de ansiedad se obtuvieron mediante la aplicación de la escala de Ansiedad Dental versión corta (SDAI). Resultados: De los 120 pacientes encuestados que acuden a la Clínica Odontológica de una Universidad Peruana; el 20% no presentó ansiedad, el 43,3 % presentó ansiedad leve, el 20% presentó ansiedad moderada y el 16,7% presentó ansiedad severa. Se evidenció mayor frecuencia de ansiedad en el momento en que el odontólogo alista la jeringa con la inyección de anestesia (23,4%) y menor ansiedad cuando va en camino al consultorio del odontólogo (10,8%). Se encontró asociación estadísticamente significativa con el género de los pacientes (p<0,01), observándose mayor ansiedad en los hombres que en las mujeres. Conclusiones: La mayoría de los pacientes que acuden a la clínica odontológica de una universidad peruana presentan ansiedad ya sea leve, moderada o severa.

Objectives: to determine anxiety levels in patients attending the dental clinic of a Peruvian university. Material and Methods: The study was non-experimental and cross-sectional during the month of September 2016. The sample consisted of 120 patients who attended the dental clinic of a Peruvian university which was selected by non-probabilistic sampling. The selection criteria were all patients of both sexes, over 18 years, who were attended on more than two occasions and who signed the letter of informed consent, data to determine anxiety levels were obtained by applying the Scale Dental Anxiety Short Version (SDAI). Results: Of the 120 patients surveyed who come to the Dental Clinic of a Peruvian University; 20% did not present anxiety, 43.3% presented mild anxiety, 20% presented moderate anxiety and 16.7% presented severe anxiety. A greater frequency of anxiety was evidenced at the time when the dentist readied the syringe with the injection of anesthesia (23.4%) and less anxiety when going to the dentist's office (10.8%). A statistically significant association was found with the gender of the patients (p < 0.01), with greater anxiety observed in men than in women. Conclusions: The majority of patients who attend the dental clinic of a Peruvian university present mild, moderate or severe anxiety.

Prognosis of Indirect Composite Resin Cuspal Coverage on Endodontically Treated Premolars and Molars: An In Vivo Prospective Study.

PURPOSE: This prospective clinical study evaluated the success rate of indirect composite resin cuspal coverage on endodontically treated molars and premolars and the survival rate of the restored teeth. MATERIALS AND METHODS: One hundred fifty endodontically treated teeth were restored with total resin cuspal coverage and randomly selected for the study. Patients were recalled after 2 to 5 years for clinical evaluation. Data were subjected to standard tests of statistical correlations using Spearman test. RESULTS: Out of the 150 teeth, 84 were molars and 66 were premolars. Of these teeth, 58.7% had mesio-occlusal-distal (MOD) cavities, 20.7% had mesio-occlusal (MO), and 20.7% had occlusal-distal (OD). A build-up procedure was performed in 51.3% of the teeth, and buccal veneer composite resins were placed at the margins of 96.7% of the teeth. Out of the 150 teeth, 30 (20%) presented margin discoloration, 3 teeth (2%) had restoration reparable fractures, 2 teeth (1.3%) had restoration irreparable fractures, and 1 tooth (0.7%) exhibited secondary recurrent caries. The opposing arch that occluded with the treated teeth presented 58% natural teeth (no restoration material), 26.7% ceramic crowns, and 15.3% implant-supported ceramic crowns. Statistically significant differences (p = 0.018) between irreparable restoration fractures and the type of support material present in the opposing arch were found. CONCLUSIONS: In a period of up to 5 years, the resin cuspal coverage of endodontic treated teeth had a success rate of 96%, while the tooth survival rate was 100%. The type of support material on the opposing arch may influence the longevity of the restoration of endodontically treated teeth.

Reduced subclinical carotid vascular disease and arterial stiffness in vegetarian men: The CARVOS Study.

BACKGROUND: Dietary habits play an important role in the development of atherosclerosis, the most important cause of morbidity and mortality in the world. The objective of this study was to verify if vegetarian (VEG) diet could be related a better profile of subclinical vascular disease evaluated by arterial stiffness and functional and structural properties of carotid arteries, compared to omnivorous (OMN) diet. METHODS: In this cross-sectional study, 44 VEG and 44 OMN apparently healthy men ≥35years of age, in order to not have confounding risk factors of subclinical atherosclerosis, were assessed for anthropometric data, blood pressure, blood lipids, glucose, C reactive protein (CRP), and arterial stiffness determined by carotid-femoral pulse wave velocity (PWV). Also, carotid intima-media thickness (c-IMT) and distensibility were evaluated. RESULTS: VEG men had lower body mass index, systolic and diastolic blood pressures, fasting serum total cholesterol, LDL and non-HDL-cholesterol, apolipoprotein B, glucose and glycated hemoglobin values in comparison with OMN individuals (all p values <0.05). Markers of vascular structure and function were different between VEG and OMN: PWV 7.1±0.8m/s vs. 7.7±0.9m/s (p<0.001); c-IMT 593±94 vs. 661±128µm (p=0.003); and relative carotid distensibility 6.39±1.7 vs. 5.72±1.8% (p=0.042), respectively. After a multivariate linear regression analysis, a VEG diet was independently and negatively associated with PWV (p value 0.005). CONCLUSIONS: A VEG diet is associated with a more favorable cardiovascular diseases biomarker profile and better vascular structural and functional parameters.